摘要
目的探讨不同体位对下肢动脉硬化闭塞患者患肢微循环及主观感受的影响,旨在为寻找有利于患者的最佳体位提供依据。方法在入院第1天,测量患者在平卧位、坐位、下肢下垂以及下肢抬高4种体位时的氧分压、疼痛评分、舒适度评分,比较4种体位患肢足背部微循环以及主观感受的改变。结果 4种体位下患肢的氧分压值比较,差异有统计学意义(均P<0.01);与平卧位比较,坐位与下肢下垂体位的氧分压较高,而下肢抬高体位的氧分压值较低,且差异有统计学意义(均P<0.05)。坐位与下肢下垂体位的疼痛评分显著低于平卧位与下肢抬高体位(均P<0.05);舒适度得分平卧位与下肢下垂体位比较,差异有统计学意义(P<0.05)。相关性分析显示,疼痛评分与氧分压呈负相关(r=-0.221,P<0.05)。结论下肢下垂体位有利于下肢动脉硬化闭塞患者患肢的微循环,而改善患肢微循环可能会降低患肢的疼痛程度及提高患肢的舒适度,因此可将其用于患者的体位指导。
Objective To explore the effects of different positions on micro-circulation of lower limb and subjective feelings of patients with lower extremity arteriosclerosis obliterans（ASO）.Methods The transcutaneous oxygen pressure（TcPO2）,pain scores and comfort level of ASO patients were measured at 4different positions（supine,sitting with the foot extended horizontally,sitting upright with legs hanging down and lying with legs elevated）on admission day.The micro-circulation of the affected limbs and patients′subjective feelings were compared.Results There were significant differences in the values of TcPO2 among 4different positions.When patients were sitting with the foot extended horizontally and sitting upright with legs hanging down,the average values of TcPO2 were significantly higher than those at supine position（P〈0.05 for both）,while the average values of TcPO2 at supine position was significantly higher than in lying with legs elevated position（P〈0.05）.The average pain score at supine position was significantly higher than that in the positions of sitting with the foot extended horizontally or sitting with legs hanging down（P〈0.05 for both）.In terms of comfort,significant differences were only seen between supine position and sitting upright with legs hanging down（P〈0.05）.The pain score was negatively related to TcPO2（r=-0.221,P〈0.05）.Conclusion Sitting upright with leg hanging down benefits the micro-circulation for ASO patients,which may reduce the pain in affected legs and improve comfort.Therefore,such posture can be recommended in clinical practice.
关键词
动脉硬化闭塞
体位
下肢下垂体位
微循环
舒适度
arteriosclerosis obliterans
body position
sitting with legs hanging down
micro-circulation
comfort
